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Scholars Journal of Medical Case Reports | Volume-14 | Issue-05
Behind the Air Pocket: Pneumocephalus Exposing an Osteomeningeal Breach Complicated by Otogenic Meningitis
Fahir Oumaima, Kazouini Imane, Moussa Achraf, Salah Ben El Hend, Badr Slioui, Salah Bellasri, Redouane Roukhsi, Nabil Hammoune, Abdelilah Mouhsine
Published: May 23, 2026 |
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36
Pages: 1188-1190
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Abstract
Pneumocephalus without trauma or surgery should raise suspicion for an underlying osteomeningeal breach and infectious origin. We report the case of an 80-year-old female presenting with fever and altered mental status whose brain CT showed extra-axial air in the frontal and right temporal regions. Bone window analysis revealed right otomastoiditis associated with a temporal osteomeningeal defect. Contrast-enhanced MRI demonstrated diffuse leptomeningeal enhancement consistent with meningitis. This case highlights spontaneous pneumocephalus as an early radiological sign of otogenic meningitis requiring urgent management.